Q1. I have been experiencing eyebrow twitching lately. Should I see a doctor?
Eyebrow twitching is an unusual eye muscle contraction. It is often triggered by factors like stress, fatigue, or the consumption of stimulants like coffee. It is usually temporary. However, for persistent twitching, it is necessary to consult a doctor to rule out hemifacial spasms.
Q2. What is hemifacial spasm?
Hemifacial spasm is the involuntary and uncontrolled muscle contraction on one side of the face, causing the eye to repeatedly open and close. In severe cases, the mouth may continuously twitch upward. Persistent symptoms can affect a patient’s daily life and social interactions. Most cases are caused by the compression of intracranial nerve fibres by blood vessels. When compressed, the intracranial nerve fibres misfire nerve signals, stimulating the facial muscles and leading to spasms on one side of the face.
Q3. How is hemifacial spasm diagnosed?
Patients will be arranged to undergo imaging, such as an MRI, to rule out nerve compression caused by tumours. An MRI can also examine the area around the nerves to determine if any blood vessels are compressing them.
Q4. How to treat hemifacial spasms?
Treatment methods can be divided into surgical and non-surgical options. Non-surgical methods may involve medication to manage symptoms indirectly, such as improving sleep and reducing patient anxiety. By addressing these underlying issues, it can help alleviate hemifacial spasms.
Aside from medication, Botox injections can be considered. Botox can block the transmission of signals between nerves and muscles, with effects lasting about three to four months. Most patients need additional injections to maintain the treatment effects.
Microvascular decompression surgery is also an option. Since the cause of the spasms is the compression of nerves by blood vessels, this procedure involves separating the blood vessels that compress the cranial nerves and placing medical materials in between to reduce misfiring nerve signals. After microvascular decompression surgery, about 90% of patients see an improvement in symptoms, with some experiencing a complete resolution. However, the surgery carries some risks. As the facial nerve is close to the auditory nerve, there is potential for damage to the nearby auditory nerve. This may lead to hearing impairment, but this risk is relatively low, at about 2%.
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